Missed Opportunity in the Treatment of Hyperlipidemia in Patients with Coronary Heart Disease: The Primary Care Setting
Posted by James
BACKGROUND
Coronary heart disease (CHD) affects approximately 13.5 million people in the United States. This accounts for significant morbidity and mortality, including approximately 900,000 myocardial infarctions and 250,000 deaths each year. A major goal for physicians caring for patients with CHD focuses on the management of risk factors known to be associated with recurrent cardiovascular events. Diabetes and hypertension have long been associated with coronary disease, and the benefit of controlling these diseases has been well documented. However, in the past 10 years, hyperlipidemia has emerged as another risk factor strongly associated with coronary disease. There is now sufficient evidence that aggressive control of hyperlipidemia has a beneficial effect. Several large, multicenter trials have shown that lipid-lowering medications are safe and effective in reducing CHD morbidity and mortality. In addition, a meta-analysis of five studies showed that the benefits of lipid-lowering is demonstrated in both men and women and in those age >65. Long-term clinical benefits have also been shown for lipid-lowering in the primary prevention setting, including patients with normal-to-only-moderately-elevated lipid levels.